1609243336 NPI number — GABRIELLE PILAR HODGES MSN, RN

Table of content: GABRIELLE PILAR HODGES MSN, RN (NPI 1609243336)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609243336 NPI number — GABRIELLE PILAR HODGES MSN, RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HODGES
Provider First Name:
GABRIELLE
Provider Middle Name:
PILAR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN, RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FRISBIE
Provider Other First Name:
GABRIELLE
Provider Other Middle Name:
PILAR
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSN, RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1609243336
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1011 W GROVE ST
Provider Second Line Business Mailing Address:
STE 120
Provider Business Mailing Address City Name:
KAUFMAN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75142-1882
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-932-1319
Provider Business Mailing Address Fax Number:
972-932-1396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1011 W GROVE ST
Provider Second Line Business Practice Location Address:
STE 120
Provider Business Practice Location Address City Name:
KAUFMAN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75142-1882
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-932-1319
Provider Business Practice Location Address Fax Number:
972-932-1396
Provider Enumeration Date:
08/28/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WP0200X , with the licence number:  180125 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0200X , with the licence number: AP129298 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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